| Background and Objective Colorectal cancer(CRC)is one of the three most common tumors in the world.In the United States,more than 40,000 people are diagnosed with rectal cancer each year.Although the etiology of colorectal cancer in the world despite a lot of research,but has not yet fully elucidated.The results of modern biology,genetics and epidemiology show that the pathogenesis of colorectal cancer is mainly related to environmental factors,lifestyle and genetic factors,is the result of a variety of factors interact.In recent years,with the continuous improvement of people’s living standards,the incidence of rectal cancer is also increasing year by year.Due to the specificity of the anatomical location of the rectum,early tumors are not easily found,most patients have been in the local late.This part of the patients after surgery alone resection rate is higher,and on the basis of surgery with radiotherapy and chemotherapy can significantly reduce the local recurrence rate and improve long-term survival,so combined surgery combined radiotherapy and chemotherapy has become the standard of local advanced rectal cancer Treatment mode.But the patient is generally poor state,can not tolerate surgery;(2)patients with strong bowel retention,do not accept permanent colostomy;(3)patients receiving neoadjuvant radiotherapy,is still not suitable for surgery,in these three cases,radical Sexual radiotherapy has become a therapeutic option that can be selected for external irradiation alone or in combination with near-radiotherapy.At home and abroad on rectal cancer radical radiotherapy research data is limited,most of the study group of patients with less.This study was conducted to evaluate the clinical efficacy of patients with rectal cancer underwent radical external irradiation combined with three-dimensional intracavitary brachytherapy to assess the therapeutic efficacy and side effects of both radiotherapy regimens and radical resection of rectal cancer Radiation therapy provides a reasonable treatment regimen.Materials and Methods Retrospective analysis of our hospital in January 2007 to December 2012 treatment of rectal cancer radical radiotherapy in 110 cases,of which 63 patients with radical external irradiation,the average age of 54.7 years,external irradiation combined with three-dimensional close-up treatment of patients 47 Example,the average age of 52.5 years old.Radiotherapy dose of DT 50 Gy / 25 f after radical treatment,the amount of infusion to p GTV plus 60 ~ 66 Gy.The dose of DT 50 Gy / 25 f in the pelvic externally treated group was: DT 10 ~ 15 Gy,5Gy / f,1f / w.Pelvic metastatic lymph nodes were irradiated with external irradiation: DT 60 ~ 66 Gy / 30 ~ 33 f.Radiotherapy during the same period of chemotherapy to give capecitabine monotherapy.After the end of radiotherapy for patients with the efficacy and side effects of regular follow-up.Results 1.The complete remission rate(c CR)of the radical external beam radiotherapy group and the brachytherapy group was 34.3% vs 37.2%,P > 0.05,the difference was not statistically significant.;2.The 3-year OS of the radical external beam radiotherapy group and the brachytherapy group was 60.3% vs 65.9%(P> 0.05),the difference was not statistically significant,the DFS was 33.3% vs 29.8%(P> 0.05),the difference was not Statistically significant,LC were 69.8% vs 80.9%(P <0.05),the difference was statistically significant.3.Acute treatment-related side effects: The incidence of acute intestinal stages 1-2 of the radical external beam radiotherapy group and the brachytherapy group were 62.7% VS 60.5%(P> 0.05),the difference was not statistically significant,the reaction stage 3 of 4.5% VS 2.3%(P> 0.05),the difference was not statistically significant;1-2 acute stage of bladder reaction was 7.5% VS 4.8%(P> 0.05),the difference was not statistically significant,level 3 Response was 2.9% vs 2.2%(P> 0.05),the difference was not statistically significant.4.Long-term treatment-related side effects: radical brachytherapy and external beam group grade 1-2 bladder side effects rates were 17.4% VS 8.5%(P <0.05),respectively,3 side effects rates were 7.9% VS 4.2%(P <0.05),the difference was significant;grade 1-2 intestinal side effects rate was 32.8% VS 46.5%(P > 0.05),the incidence of grade 3 was 31.4% VS 25.6%,respectively(P> 0.05),the difference was not statistically significant.Conclusion 1.Rectal cancer combined with three-dimensional close-range treatment compared with radical external irradiation,the pelvic local control rate has increased,1-3 grade urinary tract adverse reactions were significantly reduced.2.There was no significant difference in clinical complete remission rate,3-year overall survival,disease-free survival,intestinal acute and advanced side effects.3.Three-dimensional endoluminal brachytherapy of rectal cancer is a safe,effective,relatively less side effects of radical radiotherapy push the way. |
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